Greater Patient Delays for Women With STEMI Compared With Men

In men but not women, total occlusion of the culprit artery, stent thrombosis, a Killip class of 3 or greater, and presentation during off-hours predicted delays.

HealthDay News — Because of greater patient delays from symptom onset to first medical contact, female patients with ST-segment elevation myocardial infarction (STEMI) experience greater total ischemic time than male patients, according to a study recently published in the European Heart Journal: Acute Cardiovascular Care.

Matthias R. Meyer, M.D., from Triemli Hospital in Zurich, and colleagues compared patient delay (symptom onset to first medical contact) and system delay (first medical contact to percutaneous coronary intervention-facilitated reperfusion) between 967 women and 3,393 men in a STEMI treatment network. Trends were analyzed from 2000 to 2016, with additional comparisons between three periods (2000-2005, 2006-2011, and 2012-2016).

The researchers observed an independent association for female gender with greater patient delay (P = 0.02 versus men), accounting for a 12 percent greater total ischemic time among women in 2012 to 2016 (median, 215 minutes for women versus 192 minutes for men; P < 0.001). Median system delay was reduced by 18 and 25 minutes in women and men, respectively, from 2000-2005 to 2012-2016 (P < 0.0001 for trend; P = not significant for gender difference). In men but not women, total occlusion of the culprit artery, stent thrombosis, a Killip class of 3 or greater, and presentation during off-hours predicted delays.

“In this contemporary analysis of a large STEMI treatment network, women and men experience equal reductions in system delays, yet women continue to have greater patient delays that have remained unchanged for more than a decade,” the authors write.